Explanation of gestational diabetes & a personal reflection of what to expect if you are diagnosed during your pregnancy. Not to worry, it’s can be managed!
When you’re pregnant many people love to say “Now you can eat for two!” or “Your pregnant, this is the time you can eat what you want!”
Unfortunately, these words of wisdom are not entirely accurate. Every mom-to-be dreads the glucose tolerance test, which involves ingesting a high concentration of glucose (a form of sugar) mixed with water to see if you have gestational diabetes. It’s a grueling test because you have to sit in a doctor’s office or clinic for a few hours while they take blood samples before and 2-3 times after you drink the solution.
Before the test, you have to fast for 8 hours and this alone makes mamas pretty aggravated but then with the drink solution you have to deal with a sugar high!
Waiting for the results, you cross your fingers and hope that the last 24-28 weeks you’ve had a balanced, healthy diet. I knew that I had increased my carbohydrate and sweet intake more than before I was pregnant, but I was hoping the test would still be negative. Unfortunately, when I got the call from my doctor who then said I had gestational diabetes, my first reaction was guilt. How could I have done this to my baby?
Gestational Diabetes 101
I want to make sure I disclose this upfront, I am NOT a doctor, I’m just sharing my experience with gestational diabetes. My daily pregnancy routine consisted of exercising five times a week and eating healthy on most days. However, I knew I could have eaten healthier in the last trimester, but I didn’t (those darn cravings and ravishing bouts of hunger!).
As I learned more about gestational diabetes, I realized that our bodies change so much during pregnancy, especially with hormones and weight gain. Don’t worry this is completely normal although it may make it harder for your body to produce or use insulin. That is the hormone responsible for helping glucose (sugar) leave your bloodstream and be converted to energy. This causes glucose to be built up in the blood resulting in high blood sugar (hyperglycemia).
The good news is that gestational diabetes can be controlled by a change in diet and increase in exercise (if permitted), so I decided to make this a positive situation!
My doctor immediately had me enrolled in the Sweet Success Program at Hoag Hospital in Newport Beach (covered by insurance thankfully!). The program was intended for me to get control of the situation as I began my last trimester. I was excited, (okay – so my inner science nerd way excited) to learn more about diabetes, the risks, and what to do to get my blood glucose levels in check. Most interestingly, I learned about the recommended diet for my personal needs and how food directly affects my body.
During the Sweet Success program that was taught by registered dieticians and nurses, we learned the following things about gestational diabetes:
• The pathophysiology and managing gestational diabetes
• The impact on the mother and baby
• Blood glucose monitoring
• Nutrition education for pregnancy
• Appropriate energy needs to meet optimal weight gain for pregnancy
After taking the first few lessons, I learned that there are 3 things to help keep my blood sugar level from spiking throughout the day and to have a healthy weight gain (for mommy and baby):
1. Diet Regulation and Portion Control
Based on your personal information (weight and height) your Body Mass Index (BMI) is calculated which is important to determine what would be a healthy weight gain for your pregnancy. Through the gestational diabetes program, a meal plan was created for me by a nutritionist. This is based on the recommended calories and types of food I should be eating throughout the day to control my blood glucose levels.
Here are the basic guidelines:
- Eat 3 small meals and 3 snacks a day!
- Breakfast is the smallest meal and should be eaten within 1 hour of waking up.
- Carbohydrates should be limited at breakfast. Your pregnancy hormones are at its peak and cause insulin resistance, making it harder for your body to handle carbs in the morning.
- Which means: NO fruit, fruit juice, milk, lattes or yogurt for breakfast. Even caffeine may increase blood sugars.
- Always eat a small balanced snack before bed. NO fruit or milk before bed. Not eating a snack will prevent the liver from releasing sugar into the bloodstream while you sleep which can lead to high sugar numbers before breakfast the next day.
- Don’t go longer than 10 hours from the last snack to breakfast.
I was given a 2000 calorie based diet and was taught about food exchanges, so I could accurately plan each meal throughout the day. You don’t have to give up everything you love like chips, fast food, and sweets, but they will become a once in a while smaller “treat.”
I found it easier to get in the mindset of eating healthy and trying to avoid those calorie-dense and nutrient-void foods whenever possible. I may indulge once in a while, but I did not eat nearly as much of the bad stuff. I even found that it made me feel pretty terrible!
This was especially the case when I got the occasional high glucose reading after a meal. The good thing was that I made smarter choices on the next eating occasion to get my glucose levels back on track.
2. Balancing types of foods
- Contrary to belief, the recommendation is not to stay away from carbohydrates. It’s more about selecting carbohydrates that don’t spike your blood sugar and to eat them in combinations that include protein and fat.
- Get the recommended 28 grams of fiber per day. Eating foods with fiber helps to delay the absorption of sugar into your blood. So foods like apples, oats, legumes, and high-fiber bread may have this effect.
- Drink at least 64 ounces of water per day to keep you regular and hydrated!
- Nourish you and your baby with balanced sources of energy and nutrients from food and supplements.
For example, my night time snack before bed would be half a slice of Trader Joe’s high fiber bread, a teaspoon of nut butter or a small serving of nuts (6-8 pieces), string cheese or 1/4 cup of cottage cheese. This gave me a balance of carbohydrates, fiber, fat, and protein, leveling my glucose throughout bedtime and keeping it low at my first fasting reading.
3. Timing, Eating and Glucose Testing
Pregnant woman with gestational diabetes is recommended to eat 6 small meals throughout the day, about 2-3 hours between meals. Most likely the most dreaded part of having diabetes is taking your blood glucose reading 4 times a day, and yes, it involves needles. However after the first few days and figuring out the right settings on your device for getting the blood sample, it’s quite easy and painless, it becomes second nature to you.
When to Test:
- Fasting blood glucose – right when you wake up in the morning, not more than 10 hours from the last time you ate the night before.
- After breakfast – 1 hour after eating, measured by the last bite you take.
- After lunch – 1 hour after eating, measured by the last bite you take.
- After dinner – 1 hour after eating, measured by the last bite you take.
These testing periods are important because it allows you to know how efficiently your body’s hormones are regulating the metabolism and uptake of glucose. As a side benefit, knowing that you have to test makes you accountable for making healthier choices at each meal (at least it did for me).
You will be provided with the proper guidelines on what your blood glucose level should be below after each testing period. For me, it was less than 90 mg/dL (fasting glucose first thing in the morning), and less than 130 mg/dL after each meal. The Accu-check Nano Blood Glucose Monitoring System and lancet device used to give you your blood glucose readings are nice and compact, and super easy to use. I bring my kit with me wherever I go. However, I make sure not to leave the test strips in the sun or heat as it can damage them.
I have to admit, I thought that having gestational diabetes was going to be a huge burden to my already hectic daily routine. Although after the first week of testing, logging my results and getting used to my new diet, I felt that this was a blessing in disguise.
I felt less uncomfortable (feeling of fullness or indigestion) after each meal when following the rules. I ate more balanced and the amount that I needed (not what I wanted, which is usually a lot). I also felt that the smaller meals prevented me from the food coma and crashing that I used to feel.
Recipes for Gestational Diabetes
Here are some yummy recipe suggestions that I created that have kept my blood glucose levels from spiking:
Lunch & Dinner:
The Follow Up
After my 31 weeks check up the ultrasound showed my baby was doing well and not gaining over the average amount of weight. I even stayed steady or gradually increased weight from a month ago, success!
In a weird way, I was looking forward to monitoring my glucose levels, which will continue until after delivery (glucose re-test at 6 weeks) when your hormones re-balance and the doctor says you are no longer need to test. My goal is to maintain a healthy lifestyle because of this experience and prevent the onset of type 2 diabetes later in life!
For those wondering how having gestational diabetes might affect the second pregnancy. I’m happy to report that I had my daughter Olivia in 2017 with no diabetes. Whoo-hoo!